We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Images in Neurology |

“Blinding” Empty Sella Can Lumbar Puncture Be Avoided?

Paolo Frassanito, MD; Pasquale De Bonis, MD; Carmela Grazia Caputo, MD; Annunziato Mangiola, MD; Angelo Pompucci, MD; Carlotta Ginevra Nucci, MD; Gianluca Trevisi, MD; Carmelo Anile, MD
Arch Neurol. 2012;69(7):932-933. doi:10.1001/archneurol.2011.2137.
Text Size: A A A
Published online


Primary empty sella syndrome is an anatomicoclinical condition characterized by radiological evidence of sellar arachnoidocele (unrelated to previous surgical or radiotherapeutic treatment of this region) and is associated with endocrine disturbances and signs of intracranial hypertension (headache, visual disturbances, and papilledema), especially in young women.1 We report on an unusual case of empty sella disguising the diagnosis of an ocular inflammatory disease.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Graphic Jump Location

Figure. A, Sagittal T1-weighted magnetic resonance imaging scan with gadolinium enhancement revealing a large arachnoidocele in the sella turcica (arrow) that is pushing down on the sellar floor the pituitary gland and stretching the pituitary stalk. B, On the ultrasonographic A-scan, a maximally wide defect representing the lower reflective optic nerve in between steeply rising or falling surface spikes (corresponding to the lateral and nasal arachnoid surfaces of the optic nerve sheaths) indicates the maximum diameter of the optic nerve (distance) in the area scanned by the beam. C, The longitudinal ultrasonographic section (B-scan) rules out papilledema (arrow) and shows macular retinal serous detachment (arrowheads) and diffuse thickening of the choroidal layer (asterisk). The diffuse vascular leakage that is shown in the fluorescein angiographic scan (D, arrow), which is associated with the subretinal serous collection shown in the optical coherence tomographic scan (E, double asterisk), confirms the diagnosis of choroiditis. OD indicates oculus dexter.




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

2 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles